Creating a Seamless Evaluation and Assessment Process

Maryland has created a seamless Birth through Five System of Services to support infants, toddlers and young children with disabilities and their families. While the process of evaluation and assessment in early intervention is individualized for each child and family, the steps in the process are similar.  From the moment of first contact, it is critical to begin establishing rapport with the family.

Engage families in conversation to find out why they, or another referral source, have contacted the early intervention program. Share information with families about the early intervention system.  Welcome the family by being respectful of family culture and circumstances, and learn how the family prefers to share and receive information. Acknowledge the family’s expertise and ask about their child’s interests and capabilities.  It may be helpful to organize the conversation around the three early childhood outcomes (develop positive social-emotional skills, acquire knowledge and skills, and take action to meet needs) when discussing reasons for referral to the program.  Additionally, the purpose of the early intervention program can be explained within the context of the overarching child and family outcomes.

If the family is interested in moving forward with evaluation and assessment, specific initial steps in the process are completed:

• Provide the family with prior written notice.
• Obtain informed written consent for screening (as appropriate), evaluation and assessment, and release of medical records, as necessary.
• Conduct screening, as appropriate and determine the next steps in the referral process.

As a family moves on to evaluation and assessment, it is essential to explain the purpose and the process of evaluation and assessment, including the importance of gathering information about the family concerns, priorities, and resources. At this point in the process, the following steps are critical:

• Gather information about the family’s concerns and priorities for their child and family.
• Gather information about the family’s resources to assist in addressing priorities and concerns.
• Use open-ended questions to gather information about the family’s everyday routines and activities, including the child’s behavior and interactions with others across settings and within the context of the three early childhood outcomes.
• Begin to discuss with the family the formal or informal supports they use or would like to use including information about community programs, resources and/or services.
• Identify the role the family may want to play in their child’s evaluation and assessment and the methods/tools to be utilized.

The composition of the evaluation and assessment team is finalized and the evaluation and assessment is scheduled with the family and the team at a place and time convenient for the family. The following steps are accomplished in this stage of the process:

• Conduct the evaluation and assessment methods to identify the child’s developmental status and unique needs in each of the five developmental area as well as the functional strengths and needs across the three early childhood outcomes.
• Prepare a written report and provide as soon as possible to the family.
• At an IFSP team meeting, review and summarize evaluation and assessment results and share perspectives of all team members.
• Determine whether the child is eligible for early intervention services.
• If the child is not eligible, provide prior written notice and explain procedural safeguards, including procedures to resolve any disagreements.
• Document the eligibility determination in a written statement which is dated and includes both the names and titles of the qualified personnel and the basis for the eligibility determination.
• Begin discussions with the family about the IFSP development process.

Prior Written Notice [13A.13.01.11]

Prior written notice must be provided to parents prior to the evaluation of a child within a reasonable period.  The notice should be in sufficient detail to inform the parent of:

1. The action being proposed or refused (in this case evaluation of the child);
2. The reason for the action; and
3. All the procedural safeguards available.

Informed Written Consent [13A.13.01.12]

Informed written parental consent must be obtained prior to evaluation of a child.

All information about a child or family, and any information desired by a family, must be collected in a non-intrusive manner, with informed consent from parents or guardians.  Informed consent means that family members have had an opportunity to discuss relevant issues in order to give consent to begin evaluation and assessment, and have taken part in joint decision making with early intervention providers.  Consent must be given in writing prior to screening a child (if applicable), prior to evaluation and assessment, and in order for specific medical records to be released to the local early intervention program.  Families need to understand that their consent is voluntary, and may be revoked at any time.  If written consent is not given by parents, reasonable efforts must be made to ensure that the parent understands shy the evaluation is needed, and that neither the evaluation or early intervention services can be provided without it.

Components of a Written Report [13A.13.01.05(C)]

Results of evaluation and assessment to establish a child’s eligibility for early intervention should be documented in a written report(s).  Evaluation and assessment reports prepared by qualified personnel prior to referral to a local infants and toddlers program may be used to meet this requirement, in full or in part.

The written report should include:

• A statement of the child’s current health status based on a review of pertinent records and medical history;
• A statement describing the child’s levels of functioning in all five developmental areas (physical, including hearing and vision, communication,  social-emotional, adaptive, and cognitive) and the dates of the evaluation and assessment procedures;
• A statement of criteria, including tests, evaluation materials, and informed clinical opinion, which were used to determine eligibility for early intervention services; and
• The signatures and titles of qualified personnel who have conducted the evaluation and assessment.